Yếu tố ảnh hưởng đến việc không thống nhất dùng bao cao su ở những người có quan hệ tình dục đồng giới nam_Factors associated with inconsistent condom use among men who have sex with men in cambodia Đồng tính nam (Men sex men) và HIVLess progress in reducing HIV prevalence and incidence among men who have sex with men (MSM)(Beyrer et al 2012 CDC 2012)MSM are at greater risk for HIV acquisition and transmission due to their more hidden and stigmatized nature, compounded by limited access to basic prevention materials such as condoms and lubricant HIV prevalence in MSM ranged from 3.0% in the Middle East and north Africa region to 25.4% in the CaribbeanHIV prevalence and sexual behaviours among MSM remain of great concerns despite encouraging declines in new HIV infections in the general populationPrevalence of HIV among MSM: 2.2%Prevalence of sexually transmitted infections (STIs) among MSM: 51.5% MSM had sold sex to men in the past 12 months: 26.9% Rates of consistent condom and lubricant use with male clients in the past months: 35.7% and 49.5% Rationales and ObjectivesRationalesGreater risk for HIVLess understood due to their hidden and stigmatized natureDiscrepancy in findings in the literatureObjectives: to explore factors associated with inconsistent condom use among highrisk MSM in Cambodia
Factors Associated with Inconsistent Condom Use among Men Who Have Sex with Men in Cambodia Presented by: Pheak Chhoun, MPH Research Fellow, Center for Population Health Research Investigators: KHANA (Cambodia): Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Khimuy Tith Touro University California (USA): Siyan Yi, Carinne Brody th ICPH, Hue City, Vietnam | 26-27 September 2015 MSM and HIV • Less progress in reducing HIV prevalence and incidence among men who have sex with men (MSM) (Beyrer et al 2012 & CDC 2012) • MSM are at greater risk for HIV acquisition and transmission due to their more hidden and stigmatized nature, compounded by limited access to basic prevention materials such as condoms and lubricant (Altman et al 2012 & Trapence et al 2012) • HIV prevalence in MSM ranged from 3.0% in the Middle East and north Africa region to 25.4% in the Caribbean (Beyrer et al 2012) MSM and HIV in Cambodia • HIV prevalence and sexual behaviours among MSM remain of great concerns despite encouraging declines in new HIV infections in the general population (Vun et al 2014 & Liu 2010) • • Prevalence of HIV among MSM: 2.2% Prevalence of sexually transmitted infections (STIs) among MSM: 51.5% (Liu 2010) • • MSM had sold sex to men in the past 12 months: 26.9% Rates of consistent condom and lubricant use with male clients in the past months: 35.7% and 49.5% (NCHADS 2013) Rationales and Objectives • Rationales – Greater risk for HIV – Less understood due to their hidden and stigmatized nature – Discrepancy in findings in the literature • Objectives: to explore factors associated with inconsistent condom use among high-risk MSM in Cambodia Study design • • Cross-sectional study Two-stage cluster sampling method: – Communes (third-level administrative divisions) in each province used as the smallest unit for the sampling process – Probability proportional-to-size sampling method was used to select the required number of MSM from each commune Study population and Sample size • • • Sample size: 367 MSM Study period: April and May 2014 Inclusion Criteria: – 18 years or older – self-reported as an MSM – sexually active in the past three months – able to provide consent to participate in the study – available for a face-to-face interview on the day of the data collection Map of the Study Sites Measurements • • • • • • • Sociodemographic characteristics HIV testing history Self-perception of HIV risk Substance use Sexual behaviors Mental disorders HIV knowledge Data Analyses • • Double data entry: EpiData Bivariate analyses: – Chi-square or Fisher’s Exact test for categorical variables – Student’s t-test for continuous variables • Multivariable logistic regression model – Controlling potential confounders – Including all variables associated with condom use in bivariate analyses at the level of p< 0.05 – Soft wares: SPSS version 22 Ethical Considerations • Ethical approval: – • • National Ethics Committee for Health Research (NECHR) Written informed consent: All participants Confidentiality & privacy protection: – – No personal identifier collected Interviews at private places 10 Comparisons of characteristics of MSM who reported always using condoms and MSM who reported not always using condoms Socio-demographic characteristics Mean age (in year) Condom use in the past months Total Always Not always (n = 367) (n = 230) (n = 137) 23.9 ± 5.2 23.2 ± 4.5 25.1 ± 6.1 Gender identity Men 0.001 0.45 207 (56.4) 124 (54.0) 83 (60.6) Women 79 (21.5) 53 (23.0) 26 (19.0) Other (including ‘both’) 81 (22.1) 53 (23.0) 28 (20.4) Self-rated overall health status 0.004 Good/very good 135 (36.8) 70 (30.4) 65 (47.4) Neither good nor poor 210 (57.2) 146 (63.5) 64 (46.7) 22 (6.0) 14 (6.1) (5.8) Poor/very poor p-value* 11 Comparisons of characteristics of MSM who reported always using condoms and MSM who reported not always using condoms (Con.) Condom use in the past months Total Always Not always (n = 367) (n = 230) (n = 137) Self-rated overall quality of life